Programs and Communities

Disease burden is higher in the United States than in comparable countries. The Patient Self Determination Act of 1990 requires healthcare facilities to provide Advance Care Planning (ACP) information to all Medicare patients. The healthcare staffs’ (n=7) commitment to 3-days of ACP training increase ACP rates in the primary care setting. The Medicare Incentive Program is the platform for this initiative. This quantitative project used a valid and reliable pre and posttest design that consisted of 27 items on a Likert-scale. A 3.5-month chart audit (n=91) was conducted to assess the completion rate. Descriptive statistics was used to describe the demographic data.

The results of the two-tailed Wilcoxon signed rank test were significant based on an alpha value of 0.05, V = 0.00, z = -2.37, p = .018. There was a significant increase in the post-readiness to change average scores. A Mann Whitney test was used to analyze the statistically significant difference between the averages in two ACP types and electronic health record documentation (EHR). Staff did not always code (Mdn = 0.00) but they documented in the EHR (Mdn =1.00; 512.00, p = 0.003). ACP discussion was performed 63% of the time during Annual Wellness Visits (AWV), and there was a 49% increase in the EHR documentation. Trained staff are key stakeholders in guiding ACP conversations. They understand the barriers, impact, and consequences related to the lack of advance directives.

As of May 2022, there have been more than 80 million confirmed cases of COVID-19 across the United States, and over two million cases in Arizona. The pandemic has had a devastating impact on local, national, and global economies. This brief features the findings from data collected from a survey administered to Arizona residents in April of 2021, as well as national statistics, to understand some of the economic consequences of COVID-19 and its impacts on Arizona households.

The coronavirus (COVID-19) pandemic has affected employment and food security globally and in the United States. To understand the impacts of COVID-19 on food security in Arizona, a representative survey of Arizona households was launched online from July 1 to August 10, 2020. This brief provides an overview of changes in food security rate, perceived worries and challenges about food security, as well as behavioral changes and strategies adopted since the pandemic. Additional briefs from the Arizona survey covering topics on economic consequences, food access, and participations in food assistance programs during the pandemic are also available.

In March 2020, the COVID-19 pandemic triggered a sudden and severe economic downturn. Between February and May 2020, the number of unemployed individuals rose by more than 14 million, resulting in an unprecedented increase in the unemployment rate, which went from 3.8% in February to 14.4% in April. Even though unemployment has declined in recent months, with some individuals returning to work, the rate is still much higher than it was one year ago (7.9% in September 2020 vs. 3.5% in September 2019). Further, as of September 2020, there are 19.4 million persons unable to work due to the pandemic, as well as 6.3 million persons working only part time even though they would prefer to work more.

The coronavirus (COVID-19) pandemic led to disruptions in the food supply and high rates of unemployment and under-employment, both in Arizona and nationally. These emergencies required food assistance programs to adapt quickly and in unprecedented ways by relaxing eligibility criteria, improvising on delivery modalities, and increasing benefits. To examine food assistance program participation during the pandemic, we collected data from a representative sample of 620 Arizona households. The sample was drawn from across Arizona in July-August 2020 using an online survey. This brief provides the summary for participation in key food assistance programs, namely, the Supplementary Nutrition Assistance Program (SNAP), the Special Supplemental Program for Women Infants and Children (WIC), School Food Programs, and the emergency food assistance provided through food pantries.

With more than 19 million confirmed COVID-19 cases across the United States1 and over 500,000 in Arizona as of December 2020, the ongoing pandemic has had devastating impacts on local, national, and global economies. Prior to the pandemic (February 2020), based on U.S. Bureau of Labor Statistics data, the unemployment rate in Arizona was 6.5%, compared to 4.9% at the national level.3 Since the beginning of the COVID-19 pandemic (March 2020), the United States has experienced striking increases in the unemployment rate, reaching 13.2% in April. Similarly, in Arizona, the unemployment rate jumped to over 13.5% in April. The unemployment rates have since declined both nationally and in Arizona but remain higher compared to February 2020. In November 2020 (the most recent data available), the national unemployment rate was 6.7%, while in Arizona the rate was 7.8%—the 10th highest unemployment rate among all U.S. states.